Making care more inclusive and accessible is a gargantuan task, but it is not beyond us. Widespread systemic change is necessary to overcome disparities in care. Meanwhile, we as individuals and institutions can work to create more welcoming experiences and more equitable care. Some changes are small, and rooted in our linguistic habits, while others require gathering resources or connecting with local communities. Here are some actionable suggestions for making your care more inclusive.
1. Start with Diversity in Your Teams and Tools
Your team should reflect the same diversity as the population they serve. Look at your hiring practices to see how you promote diversity, equity, and inclusion. Does your workplace have tools in place to limit implicit bias during the hiring process?
But just having a diverse workforce doesn’t immediately make your organization functionally diverse and inclusive. Inclusion requires that diverse voices have a place at the proverbial table, where they’re heard, respected, and included in key decision-making. Gauge the diversity of your organization not just at the entry level, but also at the leadership level.
“You need leadership buy-in…Subsequently, having a robust plan and ensuring that at every point in the work you are looking through a health equity lens. That means you need to have a diversity in perspective and at the table at all the discussions.”Chineye Anako, Health Care Hero: Chineye Anako
Next, look at your tools. Diverse, inclusive teams should shape the very technology used in care from the outset. Otherwise, we can subconsciously bake bias into our solutions, too, unintentionally building more barriers to care. Evaluate if your technology and other tools truly meet the needs of your population. Look not only at the diversity of your own team and leadership, but at the diversity of your partners and vendors.
“Making sure their project teams reflect the diversity of the populations they serve is of paramount importance to the service…Inclusivity is the watchword, the panel said, agreeing that experience designers needed to include people from a diverse range of backgrounds and with a wide range of needs from the start.”Amanda Barrell, Ensuring accessibility: Crossing the digital divide in healthcare
2. Use Inclusive Language
A simple, immediate change you can make is to use inclusive language. For many in the LGBTQIA+ community, the difference between inaccessible and accessible care is as simple as feeling welcomed and accepted. Asking about (and respecting) pronoun preferences, noting each patient’s preferred name in their chart, and engaging with and accepting various gender expressions makes a huge difference for patients.
“The more I do gender-based physical therapy, the more I have learned that the things that help in my profession really help us all. That’s asking people’s preferred names and pronouns. That’s asking people if there’s anything that can be done to make them feel more comfortable. And that’s not making assumptions about people’s sexual orientation or what type of relationships they might be in.”Katie McGee, PT, DPT as told to Amanda Lucci, ‘I’m A Physical Therapist Who Specializes in Transgender Care—Here’s What I Wish More People Knew’
3. Keep It Simple
Simplify the language you use every day to make patient communications easier and clearer – especially when caring for Deaf, hard of hearing, or Limited English Proficient patients. Get into the habit of using common words. Slow down. Use shorter sentences and be succinct. Avoid idioms and phrases that might be unfamiliar to patients. (Pro tip: communicating this way is especially helpful when you’re working with an interpreter to communicate with your patient.)
Check in with your patients as you go. Ask if they understand and give them opportunities to ask questions. Find out if they need more support or resources. If you’re working with an interpreter, be sure to communicate with the patient directly, rather than saying, “Tell her I said….” to the interpreter.
4. Leverage Technology
For many, the inclusion of technology makes healthcare feel safer and more accessible. Technology also helps overcome barriers to care like time and distance. Specialists who may not have been readily accessible before the pandemic can now quickly connect with patients via digital care.
“For trans care in particular, the expansion and the ease of the current telehealth systems during the pandemic is just phenomenal. Many state laws preventing healthcare providers from treating patients across borders were waived during the pandemic, so there are tons of trans and non-binary people who now, finally, have access to care.”Katie McGee, PT, DPT as told to Amanda Lucci, ‘I’m A Physical Therapist Who Specializes In Transgender Care—Here’s What I Wish More People Knew’
Telehealth can also empower patients to get care when they need it, with reduced wait times, from the convenience of home. Digital options allow patients to be active participants in their own care, with access to resources that were previously out of their reach.
“Prior to telehealth visits, the average appointment would take approximately two hours, but the patient would only see their doctor for 20 minutes…Alternatively, the average telehealth visit is 13 to 15 minutes long, but despite being shorter, about 53% of patients are reporting that telemedicine somewhat or significantly increases their involvement in treatment decisions.”Paul Hudson, How Technology Is Making Healthcare More Human
5. Tackle Digital Inclusion
Unfortunately, technology doesn’t close the gap for everyone. For some, technology is the barrier to care. That’s why it’s important to understand the makeup of your patient population. An older patient population, or patients who primarily speak Spanish, require individual approaches. Make digital options available – but also include alternative options.
“Digital inclusion, or ensuring that all individuals and communities, including the most disadvantaged, have access to and use of information and communication technologies, is a crucial step on that journey, he said. “It is arguably one of the most important issues of the 21st century, and the pandemic has merely amplified the need for a more digitally inclusive society.””Amanda Barrell, Ensuring accessibility: Crossing the digital divide in healthcare
Make information available via multiple mediums, modalities, and languages. For instance, you might make patient information on a specific condition available as a printed brochure in multiple languages, as a video with closed-captioning in multiple languages on a website or app, or via phone consultation with a nurse educator (where you can bring in an interpreter as needed). Never assume that your patients all have the same tools, resources, and knowledge. Always be prepared to educate and explain information that may seem obvious to you. Meet your patients where they are, rather than expecting your community come to you.
“…the truth is that at least one in five Americans lacks access to a smartphone. These patients not only lose out on follow-up information, such as second dose reminders, but they also can’t easily record their side effects or report any future COVID-19 diagnosis.”Albert Fox Cahn and William Owen, The CDC’s program to track vaccine effectiveness over time leaves out 60 million Americans
Knowing your patient population’s demographics helps you serve them better and more inclusively. Focus on taking immediate steps toward inclusion and care equity. First steps: educate yourself and make the effort to implement change, even on a small scale. Trust us, you (and your patients) will see the difference.
Barrell, A. (2021, June 9). Ensuring accessibility: Crossing the digital divide in healthcare. pharmaphorum. https://pharmaphorum.com/patients/ensuring-accessibility-crossing-the-digital-divide-in-healthcare/.
Person. (2021, June 9). Here’s How To Make Physical Therapy More Inclusive For Trans People, According To A PT. Women’s Health. https://www.womenshealthmag.com/health/a36271224/transgender-physical-therapy-katie-mcgee/.
Schwab, K. (2021, March 15). The CDC’s program to track vaccine effectiveness over time leaves out 60 million Americans. Fast Company. https://www.fastcompany.com/90614789/cdc-v-safe-vaccine-program-inaccessible-smartphone.
Schwab, K. (2021, May 17). How technology is making healthcare more human. Fast Company. https://www.fastcompany.com/90637069/how-technology-is-making-healthcare-more-human.